Chronic sucralose consumption induces elevation of serum insulin in young healthy adults: a randomized, double blind, controlled trial

Abstract

Background: Non-nutritive sweeteners (NNS) are widely consumed by humans due to their apparent innocuity, especially sucralose. However, several studies link sucralose consumption to weight gain and metabolic derangements, although data are still contradictory.

Objective: To determine the effect of acute and chronic consumption of sucralose on insulin and glucose profiles in young healthy adults.

Material and methods: This was a randomized, parallel, double-blind, placebo-controlled trial conducted in healthy young adults from 18 to 35 years old, without insulin resistance. A hundred thirty seven participants were randomized into three groups: a) volunteers receiving 48 mg sucralose, b) volunteers receiving 96 mg sucralose, and c) controls receiving water as placebo. All participants underwent a 3-h oral glucose tolerance test (OGTT) preceded by consuming sucralose or placebo 15 min before glucose load, at two time points: week zero (Wk0) and week ten (Wk10). Serum insulin and glucose were measured every 15 min during both OGTTs.

Results: Compared to Wk0, consumption of sucralose for 10 weeks provoked 1) increased insulin concentrations at 0 min (7.5 ± 3.4 vs 8.8 ± 4.1 μIU/mL; p = 0.01), 30 min (91.3 ± 56.2 vs 110.1 ± 49.4 μIU/mL; p = 0.05), 105 min (47.7 ± 24.4 vs 64.3 ± 48.2 μIU/mL; p = 0.04) and 120 min (44.8 ± 22.1 vs 63.1 ± 47.8 μIU/mL; p = 0.01) in the 48 mg sucralose group; 2) increased blood glucose at - 15 min (87.9 ± 4.6 vs 91.4 ± 5.4 mg/dL; p = 0.003), 0 min (88.7 ± 4 vs 91.3 ± 6 mg/dL; p = 0.04) and 120 min (95.2 ± 23.7 vs 106.9 ± 19.5 mg/dL; p = 0.009) in the 48 mg sucralose group; 3) increased area under the curve (AUC) of insulin in both 48 and 96 mg sucralose groups (9262 vs 11,398; p = 0.02 and 6962 vs 8394; p = 0.12, respectively); and 4) reduced Matsuda index in the 48 mg sucralose group (6.04 ± 3.19 vs 4.86 ± 2.13; p = 0.01).

Conclusions: These data show that chronic consumption of sucralose can affect insulin and glucose responses in non-insulin resistant healthy young adults with normal body mass index (between 18.5 and 24.9 kg/m²), however, the effects are not consistent with dose; further research is required.

Clinical trial registry: NCT03703141.

Keywords: Glucose; Insulin; Non-nutritive sweeteners; Placebo-controlled trial; Sucralose.

Fig. 1

Flow chart of the study. The flow diagram shows the progress of the participants who were recruited, randomized and followed up throughout the study, according to the CONSORT (Consolidated Standards of Reporting Trials) guidelines

Fig. 2

OGTT insulin concentration values of the participants. Wk0 and Wk10 OGTT insulin curves are depicted for a) control group, b) 48 mg sucralose group and c) 96 mg sucralose group. d) Mean insulin AUC compared between Wk0 and Wk10 OGTTs for each group. Arrows indicate the time in which sucralose or water (placebo) were administered, as well as the glucose load. Data are mean ± SEM. *p < 0.05. Statistical analysis: Two-tailed t-tests and two-tailed paired-t tests

Fig. 3

OGTT glucose concentration values of the participants. Wk0 and Wk10 OGTT glucose curves are depicted for a) control, b) 48 mg sucralose and c) 96 mg sucralose. d) Mean glucose AUC compared between Wk0 and Wk10 OGTTs for each group. Arrows indicate the time in which sucralose or water (placebo) were administered, as well as the glucose load. Data are mean ± SEM. *p < 0.05. Statistical analysis: two-tailed paired-t tests

Fig. 4

Analysis of Wk0 and Wk10 glucose and insulin AUC between the sucralose exposed group (48 mg & 96 mg groups) and not exposed group (control). Data are mean ± SEM. *p < 0.05. Statistical analysis: Two-tailed paired-t tests